During the initial consultation with a cosmetic surgeon a vision and tear-producing test may be performed. If you wear contact lens or glasses you will be asked to bring them with you. At this point the surgeon will determine whether eyelid surgery needs to be done on just the lower or upper lids or on all four lids.
To prepare yourself for this procedure you should follow all of the surgeon's pre-op instructions. This will reduce the chances of problems or complications during and after surgery. Arrange for someone to take you home after the procedure and stay with you for a couple of days if you need help while recovering.
Eyelid surgery is usually done on an outpatient-basis under local anesthesia, meaning you will be awake throughout the procedure. Anesthetic is injected into and around the eyes; you will also be given intravenous or oral sedation. These medications help you feel relaxed and calm. You will feel no pain during surgery, though you may experience a tugging sensation around the eye, which is normal. If you are uncomfortable with the thought of being awake during surgery, general anesthesia is always a possibility. Most surgeons don't have a problem with this.
Eyelid surgery usually lasts from one to three hours, depending on the specific procedure being performed. If four lids are being worked on, the surgeon begins on the upper ones first, then moves to the lower lids.
Incisions are made in the creases of the lids and right below the lash lines; they naturally follow the lines of the eyelid. Such incisions may also extend into the outside corners of the eyes. The surgeon separates skin from muscle, and removes excess fat and underlying fatty tissue through the incisions. Sagging skin and muscle are sometimes trimmed at this point. The incisions are then sutured using the tiniest suture materials.
After eyelid surgery your eyes will feel greasy from the ointment applied to them. Bandages may be applied to the eyes, too. As the local anesthetics starts wearing off, you will feel soreness and tightness around your eyes. Your surgeon will provide you with medication to keep this discomfort and pain under control. For many days following this procedure, you must keep your head elevated. Ice compresses must be used off and on for the first few days to keep bruising and swelling under control. Follow your surgeon's directions on how to clean the eye areas every day when at home; this is extremely important in order to keep infection from setting in. Use any eye drops you've been prescribed. Two to fourteen days after surgery, the sutures will be removed.
Complications associated with eyelid surgery include infection, double vision, blurred vision, itching, swelling, redness, bruising, pain, discomfort when sleeping or closing the eyes, a slight asymmetry of the eyes and white heads that may appear once the bandages are removed.